Effectiveness and Safety of Suprachoroidal Injection of Triamcinolone in Patients with Resistant Macular Edema

Abstract

Objective: To assess the effectiveness and safety of suprachoroidal injection of triamcinolone acetonide for treatment of resistant macular edema.
 Study Design: Non-randomized, pre-post experimental study.
 Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan and Combined Military Hospital, Bahawalpur Pakistan, from Nov 2020 to Jul 2021.Methodology: Patients with age of 18 years and above, either gender, diagnosed for macular edema due to diabetic macular edema, choroidal neovascularization, pseudophakic macular edema were included in the study. Triamcinolone acetonide 40 mg/ml, 0.1 ml was administered into suprachoroidal space as study intervention and post procedural follow-ups for week 1, week 4 and week 8 were performed. 
 Results: There were 37 total patients enrolled, 30(81.1%) were males while 7(18.9%) were females with mean age of 54.65±14.8 years. At baseline, the mean value of visual acuity was 0.84±0.33, which improved to 0.77±0.35 on week-1 follow up, 0.61±0.38 on week-4 and 0.58±0.44 at week-8 follow up. At baseline mean central macular thickness was 449.4±117.2μm, which decreased to 400.5±93.9μm, 365.1±95.1μm and 354.9±92.1μm at week 1, 4 and 8 follow up. It was observed that 16(43.2%) patients reported to experience pain at injection, while remaining 21(56.8%) did not experience pain.
 Conclusion: It is concluded that single dose of triamcinolone injection administered via suprachoroidal route of administration is found to be safe and effective treatment modality for patients suffering with resistant macular edema.Keywords: Central Macular thickness macular edema, Suprachoroidal administration, Triamcinolone acetate.